The impact of repeated family and care placement breakdowns on the development of a child: a psychodynamic perspective

By Kate Lawrence

Date Posted: Sunday, 12 June 2011

Kate Lawrence is a senior residential child care worker in the west of England. She has worked in children’s homes for 15 years.

The impact of repeated family and care placement breakdowns on the development of a child: a psychodynamic perspective

It is widely argued that the parenting exemplified by Winnicott’s notion of ‘good enough’ allows individual children to develop emotional stability and thus helps them to achieve a good sense of themselves and socialisation. In this article I attempt to consider some aspects of John Bowlby’s attachment theory – together with Rutter’s critique of Bowlby – by tracing its source through Freud’s position on child development, through Erikson’s developmental stages before finally I linking these to Winnicott’s idea of what it is to be a “good enough” parent. My only purpose in doing this is in the context that these theories may help me take a concerned and more informed look at the experience of children in our care system, particularly those who are frequently moved from one care setting to another and consequently do not receive consistent parenting. To assist me in this I recount part of the history of a young woman, whom I have called Emerald, that I worked with in a children’s home some years ago. I have fictionalised a number of aspects of her life to ensure that she cannot be identified and that her privacy is respected.

Maternal Deprivation

Psychodynamic thinkers from Freud to Winnicott have understood that those children who, as they grow from infancy through to adulthood, do not achieve or receive what they need for successful emotional and social development, may suffer emotional and social problems in later childhood and in adulthood. In his theory of attachment, Bowlby maintained that a child forms a special relationship with his or her mother which is ‘qualitatively different’ from any other relationship. He suggested that the attachment between mother and child is forming through the first six months of the infant’s birth and that if this bond were broken the infant would not become socially developed and might, at a later stage, tend to become delinquent. In a research study in which he considered 44 male adolescents who had committed delinquent acts, he found that 17 of the 44 young men in his sample had been separated from their mothers for a significant period before the age of five years. From this evidence Bowlby concluded that early maternal deprivation affected a child’s development. He went on to state that the child who lacks a special relationship with his or her mother, would not be able to form relationships with other people and would not conform to socially accepted norms.

If we accept Bowlby’s position then it has significance for young people who are looked after in care, since many of them have experienced maternal deprivation at a young age. Moreover Bowlby’s argument that the damage caused by maternal deprivation is irreversible does not hold out much encouragement for those who work to help young people who have experienced family breakdown followed by a number of failed placements in care settings.

Michael Rutter (1972) disagreed with Bowlby’s views. In Rutter’s study of adolescent boys which examined whether there was a relationship between delinquent or anti-social behaviour and early separation due to hospitalisation or family problems it was found that when children returned to a consistently stable home environment after hospitalisation or other institutionalisation, they would settle down and in fact be less inclined to anti-social behaviour. Nonetheless Rutter felt that family arguments and an unsettled environment were causes of anti-social behaviour in young people.

Rutter also argued that Bowlby was mistaken about drawing conclusions about maternal deprivation because Bowlby related his studies of children to Harlow’s studies of monkeys. Rutter felt the generalisations which Bowlby drew from both his own and Harlow’s work were invalid because of the differing qualities and methods in their studies. Rutter argued that whereas Harlow was examining privation in monkeys, (that is, lack of a mother), Bowlby had conducted a study of deprivation, (that is, loss of a mother). He pointed out too that while Harlow had used an experimental method, Bowlby had used an observational method. Rutter also thought that it was not valid for Bowlby to generalize about human behaviour from an experiment with monkeys.

What is relevant is that Rutter, unlike Bowlby, held out hope for those who offered care to children and young people because he concluded that even if a child had experienced early family disruption, a subsequent period of consistent stable care would allow the child an opportunity for emotional and social reparation. However, Rutter accepted the main conclusions of Bowlby’s research: that a child who suffers maternal deprivation at an early age would be emotionally damaged by the experience. Bowlby’s basic views are still generally accepted. My own experience suggests many children in care tend to have their early deprivation reinforced by multiple care placement breakdowns throughout their developing years.

Child development and psychodynamic theory

Before I begin to present the particular case of a young person I worked with, I wanted to think about what is meant by “good enough” development. Many theories have been put forward about this even if the exact phrase “good enough” has not been used. In this article I have chosen to consider the positions proposed by two psychodynamic theorists, Sigmund Freud, and Erik Erikson. I selected Freud because his ideas are the well spring of psychodynamic thought and I decided upon Erikson because I find his ideas on human development easy to understand.

Sigmund Freud’s psychosexual stages and the Oedipus complex

Freud believed that attachment occurred during the first five years of life, and that its development was related to the different psychosexual stages which, Freud argued, every child went through. The significant stages were the oral stage, the anal stage and the phallic stage, (the latter at about 4/5 years old). Freud’s emphasis was on boys, and his main idea about attachment was of how a boy developed an unconscious desire for a sexual relationship with his mother, and began to see his father as a rival. However the boy would decide, unconsciously, to “identify with the aggressor” that is, join sides with the father for fear the father might castrate him. (This was based on the story of King Oedipus). During the phallic stage the boy learned to identify with his father, through the resolution of the Oedipus complex. Other Freudian theorists applied the same idea to girls, saying that girls developed penis envy, because they believed themselves to be already castrated. This they argued leads a girl to seek a strong love attachment with her father, and she finally identifies with her mother in order to become like her. This is known as the resolution of the Electra complex.

Freud thought that the personality of a child began developing in childhood through interaction with his or her parents. For Freud the personality was made up of the id, the ego and the superego. A balance between these three parts meant that the personality as a whole was balanced, and the person had no mental or emotional problems. If the three parts were out of balance, then the person experienced problems. For Freud the id represented our primitive drives and instincts while the superego was a kind of conscience, and took the role of an internal authoritarian father. The ego, Freud argued, protected us from the excesses of the id and superego and enabled us to keep in touch with the reality of the external world. The successful development of the adult personality would depend on how well these phenomena were kept in balance. If for instance the superego (internal strict father) was too well developed, as consequence of the child having overly strict or protective parents, the adult would feel oppressed.

Eric Erickson’s psychosocial theory of human development

Erik Erikson, a Danish/American psychoanalyst put forward a psychosocial theory of development based on Freud’s idea that children have to move through and deal with different developmental issues, the aforementioned oral, anal and sexual phases. According to Freud if these developmental impulses were not gratified and resolved, infantile behaviours were likely to continue into adulthood. Erikson however superimposed upon Freud’s developmental impulses the idea of psychosocial stages.

Erikson suggests that as the the infant grows into the child, then towards adolescence and adulthood there is a simultaneous emergence of different biological and psychological stages which contain issues that had to be dealt with. They are influenced by the social aspects of our environment. He argued that at different stages of our lives each of us must contend with these issues – how to trust ourselves, trust others, what our identity is, and among other matters, how we can be intimate with others. Erikson believed these issues were constant throughout life, but that each is relevant at specific stages of our lives. He also believed that failure to resolve the content of one of these stages at the time when it is critical has long term effects on our self-concept and on our relationships with others.

Emerald

I now wish to consider in the light of the theories I have been discussing, Emerald, a 15 years old young woman I worked with some years ago in a children’s home. Emerald was born into what is described as a “nuclear family” and when she was still very young her parents had another child. Soon after this her parents separated and for some time Emerald remained with her mother. At the age of seven, Emerald, who often visited her father, said she wanted to live with him, and both her mother and her father agreed to this. Emerald was very close to her father until he brought his new partner to their home. It was thought that Emerald could not get used to sharing her father’s attention and she did not have a good relationship with her father’s partner. Both her father and his partner said they found Emerald’s behaviour increasingly difficult to manage and they believed that Emerald was attempting to sabotage their relationship.

At the age of ten she returned to live with her Mum who now had a new partner with whom she had a child. It seemed to Emerald’s mum and her step-dad that she did not fit in with their new family, and they found Emerald’s behaviour increasingly disruptive and too difficult to cope with. At eleven years old Emerald went to live with her Gran, but this did not work out, and after Emerald alleged that her Gran had been hitting her, she was placed with a foster family who lived a long way from her Mum, her Dad, and her Gran.

She remained with the foster family for two years until she alleged that one of her foster brothers had touched her inappropriately. At the age of fourteen years Emerald was placed in the children’s home where I worked and where I met her. She often told me how she felt excluded from of each of her three families, being a member of each but not feeling wanted or loved by any of them.

When Emerald came to live at the children’s home, she did not attend school and was missing all the socialising that school provides. Her behaviour could be described as delinquent and ant-social. It included excessive verbal abuse, drinking, begging from strangers on the street for money and cigarettes, and shoplifting. She was also promiscuous.

In these ways she placed herself in situations, which were dangerous and made her very vulnerable. When she communicated with her family she told them that she was ill and needed medication or needed to go to the doctor. Although it proved impossible to find any foundation for her claims, Emerald said she experienced severe stomach pains, sickness, and excessive bleeding during her periods but my colleagues and I as well as health practitioners could not find any evidence of these claims She admitted herself to hospital on a number of occasions complaining of stomach pains but the medical staff were unable to find anything to substantiate her complaints.

Emerald stayed at our children’s home for almost 2 years. At the time she left us she had found herself a place on a computer course at the local college of further education and had applied successfully for a place on a leaving care project which provided her with her own apartment and some outreach support. Her circumstances had improved but she continued to face difficulties. Her health was better but she still had some problems, one of which was episodes of binge drinking. Her bouts of loud and aggressive acting out had diminished but she still had an uncertain, almost untrusting demeanour in the presence of strangers and while she could make friends she found it difficult keeping them.

Discussion

Bowlby would argue that Emerald’s situation was a consequence of the maternal deprivation she suffered before the age of five years. Rutter would say that the inconsistency of her care since the first episode of maternal deprivation, as a consequence of the number of moves she has experienced, meant that she was not able to internalise socially acceptable norms. Freud would argue not only that her low self esteem was the result of an under developed ego, but that she had not been able to identify with her same sex parent, because her mother had not been around and so Emerald had not been able to resolve her Oedipal feelings and consequently she had not been able to move on to the next stage of her development. Erikson would argue that Emerald had not experienced continuity of care, so she could not develop trust in others and therefore was unable to sustain any healthy relationship.

It could be argued that all these theories offer an insight into how Emerald came to be such an unhappy young woman, and all the theories suggest that consistency of care, and undisturbed development might have led to a better childhood and adolescence for Emerald.

It is clear that Emerald was crying out for help. She didn’t know what kind of help she wanted but she needed someone to stick with her long enough so that she could have a period of stability during which she might have gained the confidence to discover who she wanted to be and what would have been best for her.

What is of the greatest concern is that the care system may be the villain in this. Too many young people who enter care have already experienced multiple changes in their family make up and too often during their “care career” they are moved from one foster family to another when difficulties crop up. All this seems to occur because there is a generally held view that foster family placements are superior to other placements no matter how many times a child has to be moved from one family to another. Too often it is only as a last resort that a young person is moved from a foster family to a children’s home. In my view this final move to a children’s home occurs when too much damage has been done to allow for reparation work to be successful. Yet all practice standards emphasise that every effort should be focused on finding a care placement for a child that is a permanent one.

This brings me in conclusion to an observation which Winnicott made about a child’s experience of good enough caring. He said that the children in care who shout out the loudest, and who act out most aggressively are often the ones who are moved from place to place and yet he suggested they are the very ones for whom we should hold out most hope. They are crying out because they know they have lost something that held promise, something that was “good enough” and made life worth living. (Winnicott,) In Emerald’s case I would argue that she received good enough parenting in her very early years when her parents were together and she lost all this when her parents became more absorbed in their own emotional needs and in a sense abandoned her emotionally even perhaps before the family had broken up. It may also be reasonable to suggest that had Emerald been placed with a view to a permanent placement in a children’s home at an earlier date she might have been given more time to come to terms with her poor experience of family after her parents broke up.